Respiratory Compromise

Detecting Deadly Post-Surgical Respiratory Dysfunction

It is crucial to understand this type of respiratory dysfunction so that it can be detected and the patient is treated as early as possible in order to save lives.

By J. Paul Curry, MD (anesthesiologist)

This is the third article in a series exploring the impact of pulse oximetry alarm thresholds in hospitalized patients. In the first article, Improving the Safety of Post-Surgical Care,” I introduced the concept that, although the current approach to physiologic threshold monitoring (triggering an alarm when oxygen saturation falls below 90%) works well in the OR, it is unreliable on post-surgical floors.

Image source: http://thedoctorweighsin.com/detecting-deadly-post-surgical-respiratory-dysfunction/

Image source: http://thedoctorweighsin.com/detecting-deadly-post-surgical-respiratory-dysfunction/

In the second post, Pulse Oximetry False Alarms on Post-Surgical Floors,” I explored in more depth why the threshold for triggering a pulse oximetry alarm should vary depending on the site of care (OR vs post-surgical floor). The key to appreciating why this is the case is understanding that the clinical conditions that threaten oxygenation on post-surgical floors are different from the type of sudden, life-threatening airway compromise that occur in ORs. Those conditions often have an insidious onset and comprise sepsis, aspiration, congestive heart failure, pulmonary embolus, and two different types of opioid-associated respiratory depression.

In this post, “Detecting Deadly Post-Surgical Respiratory Dysfunction,” I will review the pattern of respiratory compromise that characterizes the the conditions not related to opioid use. This post is a bit technical, but bear with me. It is crucial to understand this type of respiratory dysfunction so that it can be detected and the patient is treated as early as possible in order to save lives.

To read a complete copy of this article on TheDoctorWeighsIn, please click here.

Leave a Reply

Your email address will not be published. Required fields are marked *